Rely on clinical skills to diagnose ferret adrenal disease


Rely on clinical skills to diagnose ferret adrenal disease

Jun 01, 2004


Mustelidae, Ferret, 7 years old, F/S, 1.5 lbs.

Clinical history:

The ferret presented for losing hair on the tail.

Physical examination:

Editor's Note: In our ongoing telemedicine series, Dr. Johnny Hoskins presents medical case studies. The format is heavily focused on radiology and ultrasonography and details complicated, yet fairly common cases most veterinarians will be exposed to in practice.
The findings include rectal temperature 101°F, no heart murmur heard, pink mucous membranes, and nonsluggish capillary refill time at <1 second. The ferret is bright/alert/responsive, normal lymph nodes, normal abdomen, hair loss of tail, gingivitis and dental disease. There has been no therapy.

Laboratory results:

A partial complete blood count and serum chemistry profile was performed and is outlined in Table 1. Urinalysis was not done. The fecal examination is negative for parasites.

Radiographic review:

Survey abdominal radiographs are done.

My comments:

The abdominal radiographs show enlarged spleen, soft tissue mass associated with left kidney and another soft tissue mass next to the right kidney.

Ultrasound examination:

Thorough abdominal ultrasonography is performed with the ferret positioned in dorsal recumbency.

My comments:

The liver shows an inhomogeneous texture in its parenchyma. No masses noted within the liver parenchyma. The gall bladder is mildly distended, and its walls are not thickened or hyperechoic. The gall bladder does contain a lot of sludge material. The spleen is prominent (sedated used for the study) and shows an inhomogeneous texture in its parenchyma - no masses noted. The left and right kidneys are similar in size, shape and echotexture. Each kidney shows an inhomogeneous texture in the renal cortex. A large cortical cyst is present in the caudal pole of the left kidney. No masses or calculi were noted in either kidney. The urinary bladder is distended with urine and contains some urine sediment material - no masses or calculi noted.

The stomach, small intestine and pancreas are normal. The pancreas shows a decreased mixed echogenicity in its parenchyma.

An irregular-shaped echogenic area with a single anechoic lesion is seen caudal to the liver and cranial to the right kidney. An echogenic irregular-shaped area with an anechoic lesion in its parenchyma is seen in the mid-abdomen cranial to the right kidney.

Another lesion of similar shape and echotexture is seen in the right cranial abdomen, caudoventral to the liver and dorsal to the spleen.

Case management:

In this case, adrenal tumors are the primary clinical differential diagnosis. At this point, an exploratory laparotomy would be warranted to possibly remove the neoplastic process, inspect the abdominal cavity for potential metastatic disease and collect appropriate biopsies for histopathologic examination. Therapy thereafter would depend on the findings from the exploratory laparotomy and histopathologic examination.

Review adrenal tumors:

Adrenal gland tumors are a common problem for ferrets 3 years and older, although this condition can occur at any age. The most common signs of an adrenal tumor are: hair loss or thinning on the body of the ferret (in advanced cases, hair may only remain on the head and feet and some have only their whiskers remaining); loss of muscle mass and a pot-bellied appearance; thin skin or almost translucent; itchiness; excessive water consumption; aggressive or mating behavior (mating behavior with inanimate objects, i.e., their blanket, stuffed toys, etc.); and an enlarged vulva.

In males, urination difficulties may be present due to enlarged prostatic tissue and this can become life-threatening if not treated.

Adrenal disease in ferrets is usually diagnosed by clinical signs. There are no definitive tests that can be performed that will reveal adrenal disease. Standard blood work will be normal assuming the ferret is healthy in every respect except for the adrenal problem.

There is currently only one hormonal panel that will confirm adrenal disease in the ferret, which is run by the University of Tennessee, School of Veterinary Medicine - this test is often referred to as "The Tennessee Panel." Radiography and ultrasonography may be useful at times in the diagnosis of adrenal disease. Diseased adrenal glands can frequently be normal in size and shape and, therefore, will appear normal in radiography and ultrasonography.